Despite the incompletely investigated action mechanisms of apremilast, its therapeutic benefits in BS are believed to be exerted through modulation of the serum cytokine levels, including those of TNF-α, IL-23, IL-2, IL-8, IL-10, IL-17, and IFN-γ (Wakiya et al., 2022; Fukui et al., 2022). This evidence concerns the gene TNF and Bloom syndrome.